Use of insulin lispro during pregnancy in women with pregestational diabetes mellitus

Systematic Literature Review of Basal Bolus Insulin Analogue Therapy during Pregnancy

“…As suggested by these results glycemic control measured by A1c was improved in lispro groups versus regular insulin in multiple studies [22,23,26,29], except for the Garcia-Dominguez et al [30] report showing greater A1c levels in the lispro group, p=0.022 [30].…”

“…Garcia-Dominguez et al [30] demonstrated a significant increase in neonatal hypoglycemia with lispro use, but the authors suggested that this may have been due to concomitant use of an insulin pump [30]. The remaining data we found did not indicate there was any difference in rates of neonatal hypoglycemia between those exposed to in utero to regular insulin versus lispro.…”

“…GarciaDominguez et al [30] were able to demonstrate significantly lower rates of maternal hypoglycemia in lispro group versus regular insulin [30]. Interestingly, Persson et al [27] showed a significant increase biochemical hypoglycemia (<54 mg/dL) in the lispro group, although no episodes of severe hypoglycemia were demonstrated [27].…”

“…In 2011, Garcia-Dominque et al [30] retrospectively evaluated 241 parturients treated with regular insulin and NPH and 110 with various combinations of insulin analogues (most commonly, a combination of lispro and NPH) [30]. The group treated with insulin analogues had slightly higher mean A1c during T1 (6.9±1.0 vs. 6.6±1.0, p=0.022), but required smaller insulin doses throughout pregnancy.…”

Safety of insulin analogs during pregnancy: a meta-analysis

“…The results showed a significantly lower incidence of jaundice with lispro use compared to regular insulin use (RR = 0.63, 95 % CI 0.44-0.90; Table 1) [6,7,9,12]. Lispro was associated with a significantly higher incidence of LGA than regular insulin (RR = 1.42, 95 % CI 1.20-1.69; Fig.…”